Provider Demographics
NPI:1154324572
Name:SILICON VALLEY EYE PHYSICIANS
Entity Type:Organization
Organization Name:SILICON VALLEY EYE PHYSICIANS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:MOSHE
Authorized Official - Middle Name:
Authorized Official - Last Name:MENDELSON
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:408-739-6200
Mailing Address - Street 1:1010 W FREMONT AVE
Mailing Address - Street 2:STE 200
Mailing Address - City:SUNNYVALE
Mailing Address - State:CA
Mailing Address - Zip Code:94087-3019
Mailing Address - Country:US
Mailing Address - Phone:408-739-6200
Mailing Address - Fax:408-739-2439
Practice Address - Street 1:1010 W FREMONT AVE
Practice Address - Street 2:STE 200
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94087-3019
Practice Address - Country:US
Practice Address - Phone:408-739-6200
Practice Address - Fax:408-739-2439
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-31
Last Update Date:2008-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA013991207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACD9177OtherMEDICARE RAILROAD
CAGR0069750Medicaid
CA0364870001OtherMEDICARE - DMERC
CACD9177OtherMEDICARE RAILROAD
CAZZZ00843ZMedicare ID - Type UnspecifiedGROUP MEDICARE NUMBER
CA0364870001Medicare NSC